WFNJ Release of Information

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Email *

Name *

I authorize the Hunterdon County Educational Services Commission to release my records, which include: my name; social security number; address; date of birth; assessment data; attendance; and job placement record. *

I agree

Required

I understand that the above referenced information may be shared with the: Greater-Raritan Workforce Development Board; Greater-Raritan One Stop Career Center; Somerset County Department of Social Services; Hunterdon County Division of Social Services; and New Jersey Department of Labor. *

I understand

Required

I understand that the use of my records is limited to and in connection with the audit and evaluation of local, state, and/or federally supported programs, or in connection with the enforcement of the local, state, and/or federal legal requirements related to the Work First New Jersey grant program. *

I understand

Required

My typed signature below is an acknowledgement that I have read and voluntarily consent to the release of the above-mentioned information. *

Today's Date *

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